What is your preferred method of contact (to / from patients and colleagues)

[backcountryrez]

Fellow SDNers,

What is your preferred method of contact for calling patients or even other employees? The hospital already gave me a pager (I'm on-call two out of four weeks a month), but as we all know, it's not two-way like I would have liked.

Now comes the conundrum: how do you contact your patients or other employees? Do you call them from your personal number or do you go through a service? Our hospital lets use the "white phone" that will connect us with the call center who will then call the patient (and thus shows the general hospital phone number), but being that I used to work at the call center during my time as a MS, I tend to avoid it as much as possible.

Now I will call patients back with a google voice number and I have a second for employees that will call for something "urgent" (two out of ten times it's really "urgent").

Do you think my system is acceptable, or should I be giving employees my personal number? Should patients be called from an "inside line"? I know this question has been asked and beaten to death many times before (I read the ancient threads), but what do you guys do? What are your recommendations?

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[BoardingDoc]

Fellow SDNers,

What is your preferred method of contact for calling patients or even other employees? The hospital already gave me a pager (I'm on-call two out of four weeks a month), but as we all know, it's not two-way like I would have liked.

Now comes the conundrum: how do you contact your patients or other employees? Do you call them from your personal number or do you go through a service? Our hospital lets use the "white phone" that will connect us with the call center who will then call the patient (and thus shows the general hospital phone number), but being that I used to work at the call center during my time as a MS, I tend to avoid it as much as possible.

Now I will call patients back with a google voice number and I have a second for employees that will call for something "urgent" (two out of ten times it's really "urgent").

Do you think my system is acceptable, or should I be giving employees my personal number? Should patients be called from an "inside line"? I know this question has been asked and beaten to death many times before (I read the ancient threads), but what do you guys do? What are your recommendations?

Your post is very confusing. Are you asking whether you should give out your phone number to patients and/or colleagues? Or are you asking about calling those people and whether you should use an intermediary?

If the former: I give my number out to noone.

If the latter: Just dial *67 before you call or use a landline instead of your cellphone.

If you need to leave a callback number, use your google voice number for everything and simply turn it off when you aren't expecting a call.

EDIT: Corrected my typo. It's *67, not *69.

 

[backcountryrez]

I guess I left that part out when I started my post. Yes, do you think it would be advisable to share my GV numbers with patients? The callback part, I'd like to increase my efficiency, but waiting on hold for five minutes just to be patched over to another number seems archaic to me. I wrote a whitepaper for the telecom system but it was rejected due to cost feasibility.

But thank you for your suggestion!

 

[CptCrunch]

Your post is very confusing. Are you asking whether you should give out your phone number to patients and/or colleagues? Or are you asking about calling those people and whether you should use an intermediary?

If the former: I give my number out to noone.

If the latter: Just dial *69 before you call or use a landline instead of your cellphone.

If you need to leave a callback number, use your google voice number for everything and simply turn it off when you aren't expecting a call.

Should be *67

 

[Smurfette]

I do not give my cell phone number to patients. I learned very quickly that because I am "nice", patients will call me at all hours for things that often are not important or could be addressed during office hours. One of my former partners had patients who obtained her number and would text her, expecting responses, even if she was on vacation or otherwise unavailable. No thanks.

If I receive a page from a patient, I either have the paging service connect me, use *67 (not *69, which is callback and not caller ID block), or use the doximity app (which I programmed to have my office number show up on caller ID). Patients increasingly do not pick up a number that is blocked. The doximity app is pretty new but has been working out nicely. If a patient needs to call me back, I give them my office number or the number of the floor where I'm at.

With colleagues, I am generally fine giving them my cell # to ask them to call me back, or text me regarding specific issues.

I have never had to call through a service when in the hospital, but just "dial 9" to get out when in the hospital or clinic. My hospital in residency required a unique passcode to dial out from certain extensions, which everyone got as part of their orientation and was quick to connect.

 

[Bacchus]

The only time this is an issue as an attending is when I'm on call. We use TeleMed which gives us a callback option. We click call back in the app, get a call from the service center and then get connected to the patient. For 99c a call you can record the call if you want. I do not do this.

 

[ThoracicGuy]

Fellow SDNers,

What is your preferred method of contact for calling patients or even other employees? The hospital already gave me a pager (I'm on-call two out of four weeks a month), but as we all know, it's not two-way like I would have liked.

Now comes the conundrum: how do you contact your patients or other employees? Do you call them from your personal number or do you go through a service? Our hospital lets use the "white phone" that will connect us with the call center who will then call the patient (and thus shows the general hospital phone number), but being that I used to work at the call center during my time as a MS, I tend to avoid it as much as possible.

Now I will call patients back with a google voice number and I have a second for employees that will call for something "urgent" (two out of ten times it's really "urgent").

Do you think my system is acceptable, or should I be giving employees my personal number? Should patients be called from an "inside line"? I know this question has been asked and beaten to death many times before (I read the ancient threads), but what do you guys do? What are your recommendations?

You can't pay me enough to give my cell phone number out to patients or their families.

 

[Winged Scapula]

1) I vastly prefer our patient portal for communicating with patients however, will not use it for discussing surgery or biopsy results or anything else I deem important. Patients are encouraged by me to use and after months of pleading with my staff (after they complained about the number of phone calls we get during the day), they are finally utilizing it as well and encouraging patients to use it

2) I do not give my cell phone out and almost throttled one of my partners when he gave it out (he gives his pager # out and didn't think about the fact that my cell is my only number [e.g., I don't have another number] and patients can and will abuse it). One of my other partners gives out her cell # as well; I think its completely unnecessary.

If I call patients, I always block the number using #67. If they don't answer, I leave a vague message and tell them to call back. I remind patients that I will call from a blocked number, but they almost never remember to take the block of their phone in order to receive calls from private lines.

3) I am definitely ok with my office providing my cell # to other physicians and hospitals. I was not happy when they gave it to a device rep.

4) I will email although I prefer the portal; if you can email, you can portal

 

[Bacchus]

And "portaling" increases my meaningful use yadda yadda yadda. I portal if I can, bypassing the in-office nurses when possible.

 

[gutonc]

I used to *67 but got so many blocked calls and then repeat callbacks in the middle of the night (even after telling the answering service to not page me back if the patient wouldn't turn off blocked calls), that I've started using the Doximity Dialer app. It's the sole useful purpose I've found for Doximity.

I much prefer to use the "EMR Portal" option but many patients don't sign up for it, and the ones that do tend to be a little insane and I wind up calling them anyway (but at least I still get "Meaningless Use" credit).

I have a full-time triage nurse in the office (for 4 docs) so have no problem having her take care of 95% of the calls for me.

I give other docs my # without question. Much easier than dealing with my (or their) front desk staff ("Hey, Jim, give me a call about Mr. Jones when you have a minute.").

I don't give out my email to patients either. I did it once...a 27yo with refractory GBM going to Wales to visit his new wife's family for the first (and last) time. I wanted him to have a way to contact me if necessary...he never used it of course. One of my other patients got it somehow and she sends me inappropriate jokes.

 

[WinslowPringle]

I will never, ever give my phone number to a patient. If I am at the hospital, I call from a hospital phone. Patients can page me or reach through the patient portal. If not at the hospital, I'll call through the hospital operator. No nurses have my cell phone, and I have never given the operators my cell phone as an option. I have a pager, and it gives me an unpleasant feeling when it rings; I want to keep the work associated with work things and my phone for personal things. I also have a cheap burner phone for work-only stuff for attendings and fellow residents.

 

[backcountryrez]

What about this...have you ever been paged to call a patient back and then have been greeted with "you called me, i'm just calling you back?"...even though you called the patient and LEFT A MESSAGE without giving them a reason to warrant them calling you back?

 

[Winged Scapula]

yes.

Apparently people don't listen to their messages.

 

[FlowLimited]

I also use the Doximity Dialer. It works great.

 

[Amygdarya]

yes.

Apparently people don't listen to their messages.

Or just want to hear their doctor's calming voice 😛 (I'm going into psychiatry, clearly)

 

[MediCane2006]

I have on VERY special occasions given a patient my number. Otherwise I block my caller ID on my phone before calling, or just have the answering service connect me

 

[obgyny]

Sometimes patients abuse the portal too... I've had patients send me daily unnecessary messages about their condition.. or email me in the middle of the night expecting me to reply immediately....

I only give my cell to colleagues. Never to patients. I usually use the portal to message patients when possible. Or I dial out from the operator depending on the situation (even if it means being on hold). Even calling from a hospital phone (like a physician work station) can lead to patients having these numbers...


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[VA Hopeful Dr]

I think it depends. When I was doing urgent care I'd give out my number to several patients/week - the ones that I could tell were anxious, usually parents. In 1 year of this and likely giving it out 150+ times, I was called once.

 

[Winged Scapula]

Sometimes patients abuse the portal too... I've had patients send me daily unnecessary messages about their condition.. or email me in the middle of the night expecting me to reply immediately....


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Yeah, they can definitely abuse the portal.

I've only had that happen once; the patient sent me multiple messages per day, often just "chitchat" about her day. After she messaged me that she was "just driving by and saw your office light on, so almost stopped" (you can't see my office from the main road, which means she came into the office complex), I had to bring in her to discuss boundaries.

 

[backcountryrez]

Sounds like patients seem to think that "patient care" means "patient care". I almost had to change my number because I've been receiving midnight calls to refill scripts.

 

[northernpsy]

I use phones at work stations to call patients often. If they try to call that number back, well, it's not my problem since I move around the hospital. 😛

I never give out my direct cell or pager numbers to patients.
Most patients will probably respect the boundaries but all it takes is one really annoying or personality disordered patient to wreak havoc - and many very emotionally unstable people can hold it together for a while, long enough to make you think they're ok, before the extent of their pathology becomes clear.

Besides, I think many of the sensible patients with good boundaries would probably feel weird about calling you on your personal phone. I felt weird about it when I was a patient and a couple of my personal physicians gave me their cell phone numbers (I think they felt like they should as a professional courtesy even though there was no particular reason my condition required that I should need instant access to them). Chances are that the patients you actually wouldn't mind hearing from don't want to feel like they're bothering you.

 

[birchswing]

I don't think using a Google Voice account for calling patients is a good idea. At the time I researched it (a couple of years ago), Google's Business Associate Agreement was not covering Google Voice. It's inherently problematic because it's using IP to route calls whether or not the actual call transmission is a VOIP call or not.

 

[evilbooyaa]

Patients never get my cell phone number or my pager. Once so far I've given out my e-mail so that a patient could e-mail me important records that we needed, otherwise I don't want patients directly e-mailing me.

Patients call the front desk (during the day) or triage (during the night) who will page me if urgent (and I'm on call), and e-mail me if non-urgent so i can take care of it the next business day.

If I'm not at work and not on call, I do not want to hear from the hospital or a patient. Maybe it'll be different once I'm an attending.

Equal level colleagues or higher (Other residents/fellows and attendings) get my number if we're on call together. As an attending, I will likely give my referring docs my cell phone to avoid phone tag that routinely happens in clinic.

 

[obgyny]

If I'm not at work and not on call, I do not want to hear from the hospital or a patient. Maybe it'll be different once I'm an attending.

Agreed.

What's our responsibility when we get paged when we're not on call. Sometimes nurses or staff neglect to see the on call pager and continue to page me on nights/weekends when I'm off.

If my pager is near, I'll answer them and ask them to please page the on call pager from now on. But other times I don't see the page until I'm back at work.

You would think if I don't answer, they'd figure it out to page someone else. But once they delayed a needed blood transfusion several hours because they waited for me to return a page when I was asleep post-call .



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[BoardingDoc]

You would think if I don't answer, they'd figure it out to page someone else. But once they delayed a needed blood transfusion several hours because they waited for me to return a page when I was asleep post-call .

I don't know how the paging system works at your hospital, but at ours we can manually change our status to "unpageable" so if the RN tries, it will give them an error saying the page didn't go through and force them to look at who they were actually supposed to be calling.

If that isn't an option, I assume that you had a gentle reminder conversation with that RN about how they need to check the call schedule because any potential problem that arises from them paging the wrong person is ultimately on them both ethically and legally.

 

[obgyny]

I don't know how the paging system works at your hospital, but at ours we can manually change our status to "unpageable" so if the RN tries, it will give them an error saying the page didn't go through and force them to look at who they were actually supposed to be calling.

If that isn't an option, I assume that you had a gentle reminder conversation with that RN about how they need to check the call schedule because any potential problem that arises from them paging the wrong person is ultimately on them both ethically and legally.

I wish we had an unpageable option!! But no, I write very clearly in bold in my progress notes who to page and when. But it gets ignored sometimes...

I do remind the nurses. But one issue is when Pharmacy pages you. They only page the person who placed the order, so they don't know to page an on call pager.

 

[backcountryrez]

I write very clearly in bold in my progress notes who to page and when. But it gets ignored sometimes...

Selective reading must be a phenomenon in the field. More than a few times already I've asked countless people if whether or not they read my notes thoroughly. I also do them a favor by writing in block print. The drafting class offered in my HS growing up really helped in the long run.

 

[Ironspy]

How have people handled other hospital staff giving patients your personal cell phone number?

 

[gutonc]

How have people handled other hospital staff giving patients your personal cell phone number?

Report it to their supervisor. And then push them off the roof of the hospital.

 

[evilbooyaa]

How have people handled other hospital staff giving patients your personal cell phone number?

Wtf. Yell at them. Give the patients THEIR personal phone numbers and see how they like it.

I gave very few nurses on the floor my personal phone number, and the ones I did were the ones I would hang out with outside the hospital. If a co-worker gave a patient my personal cell number without my permission and I found out (most likely from the patient who didn't know they weren't supposed to have it) I would have a discussion with that person, in private.

 

[Winged Scapula]

How have people handled other hospital staff giving patients your personal cell phone number?

it's happened three times:

1,2: nursing staff provided the cell phone number to my patients despite a bolded order which said "this is my personal cell phone number to be used by nursing staff only. Do not give to patients. "

fortunately both patients who used the number to call were suitably mortified and never called again. I however wrote those nurses up and talked with their supervisor.

3. my partner gave my cell phone number out to one of his patients that I was having to take back to the operating room. He's done this before the other partners so we had a meeting and we asked that he not do that. He seems to forget that when he gives his cell phone number out that's a work number that he uses when the rest of us only have a single cell#.

It was fine although that particular patient called me several times prior to her surgery seemingly to update me on how close she was to the hospital. Not sure why that required several phone calls.

 

[Raryn]

Any doctor can have my cell phone number. As can the medical students. No patient, nurse, RD, social worker, or janitor can get anywhere close to it. I'd give a talking to to anyone who gave it out.

Otherwise, patients are all given the information on how to page the on-call fellow in my group. They rarely use it for anything as they can also just call the nurses in our clinic to take care of things like refill requests. Most of the time if I get paged, it's legit.

 

[northernpsy]

At my current job, there is a contact list that is sent out to all the RNs, case managers, etc. where our cell phone numbers are listed alongside our pagers.
I went along with that without any objection. I'd rather just get paged, but I'm not upset if a nurse or other staff member calls my cell for something that would be a legit reason to page me.

However, I would be extremely upset if a staff member gave out my cell number to a patient! Common sense should tell you not to give out that info without explicit permission. I wouldn't just let that go since it is a big invasion of privacy.

 

[Danbo1957]

As I am "on-call every moment of every day", I have a moderately priced dedicated cell-phone with T-Mobile service for work. I allow anyone to know the number. Of course, I get dozens of phone calls a day. There is a feature on my phone that sends all calls straight to voicemail, but, I can designate certain in-calling numbers to ring. Best option to screen calls and accept others. I encourage my patients to call the office, if I am unavailable for treatment, they can coordinate treatment from others.

 

[dpmd]

I don't have a pager so the answering service just calls my cell. They will call me on my patients during the day even if I am not on call unless I let them know I will be out of town (and then I designate someone else to get those calls). At night the will usually page the on call (who will take care of any little **** or have them call me for big problems). I have also given my cell phone out to numerous docs to cut out the middleman and streamline things. This lets them text me nonurgent consults which I can then acknowledge at my leisure (I have my phone set to not notify me of texts overnight) and has the side benefit of being able to text them back recommendations. If they need a quick response they can call. It does mean I get consults sometimes when not on call (sometimes because they don't check who is on call, sometimes because they or the patient prefers me). I either accept if I am in town and want to work, or I direct them to the on call surgeon.

I also give my number to the OR staff and certain floors (those I know won't abuse it) and have put it in orders as a call if XYZ is going on since as a consultant I don't always get calls when stuff is going on. Then again when I initially applied for my license I listed my cell phone which meant that many online doctor review sites had it as my office number for a while, and while I did get calls because of it there wasn't a huge problem from it. So I am not that nervous about people having my number.

 

[Spectre of Ockham]

Well the ER told us to get our asses on WhatsApp and that's what we did. Now I have to carry a phone for work and one for personal matters. FML

 

[Keona]

We have a service cell phone that gets passed between physicians. It is awesome and everyone has the number. Patients do not. If I call a patient I use doximity which works great and eliminates my need to *67 which my patients never answer and if I forget to dial it they end up with my personal cell phone number